Arch Pediatr Infect Dis. 2018 October; 6(4):e67746. Published online 2018 September 5. doi: 10.5812/pedinfect.67746. Research Article Epidemiological Aspects and Main Determinants of Prognosis in Children with Acinetobacter Infections Admitted to Intensive Care Units at Aliasghar Children’s Hospital, Tehran, Iran Alireza Nateghian 1, * , Hanieh Radkhah 2 , Niyosha Masalegooyan 3 , Masoumeh Moradkhani 3 and Masoumeh Miradi 3 1 Pediatric Infectious Diseases Department, Iran University of Medical Sciences, Tehran, Iran 2 General Practitioner, Tehran, Iran 3 Aliasghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran * Corresponding author: Aliasghar Children’s Hospital, Shariati St., Zafar St., Postal Code: 1919816766, Tehran, Iran. Tel: +98-2122226127, Fax:+98-2122223822, Email: nateghian.ar@iums.ac.ir Received 2018 February 20; Revised 2018 May 17; Accepted 2018 May 25. Abstract Background: There is not enough information about the prevalence of Acinetobacter infection as well as its risk factors, especially in neonatal intensive care units. The present research aimed at conducting a five-year study on Acinetobacter infection and its main factors in neonatal and pediatric intensive care units in Iran. Methods: This cross-sectional survey was conducted on 89 children with positive culture for hospital-acquired Acinetobacter, ad- mitted to intensive care units of Aliasghar Children’s Hospital in Tehran, between 2010 and 2015. Besides, 97 patients with similar baseline characteristics without Acinetobacter positivity were enrolled as the control group. Epidemiological information and clin- ical data were collected by reviewing the hospital recorded files. Results: In the group with positive Acinetobacter culture, complete and partial improvement was observed in 62.9% and 11.2%, re- spectively, while 25.8% died due to treatment failure. In this regard, complete and partial improvement in the control group was revealed in 85.6% and 11.3% with an overall death rate of 3.1%, indicating significantly higher failure rate in the case group (P = 0.001). To determine the main factors for in-hospital death, all variables with a significant association with positive culture in univariate analysis (considering P < 0.2) were entered in a backward multivariable logistic regression model. In this regard, venous access (OR = 7.80, 95% CI: 1.06 to 57.19, P = 0.043), carbapenem use (OR = 27.03, 95% CI: 1.93 to 377.780, P = 0.014), and ampicillin use (OR = 0.12, 95% CI: 0.019 to 0.739, P = 0.022) were shown as the main determinants for Acinetobacter-related death. Conclusions: Although the study was not a prognostic study and determination of the main determinants of prognosis in children with Acinetobacter infections was not possible yet it seems that the mortality rate due to Acinetobacter infection in the population was about 25.8% in the global range reported in the literature. The main factors for Acinetobacter infection-related death are central venous catheters related to TPN, carbapenem use, and ampicillin use. Keywords: Acinetobacter, Children, Iran, Course 1. Background Neonates, who are admitted to intensive care units are at high risk for various types of Infections, such as Acineto- bacter infection (1). Acinetobacter species are the most im- portant pathogens associated with hospital-acquired in- fections and can be accounted for up to 20% of infections in ICUs worldwide (2). This infection was initially identified within the first decade of the twentieth century and is now accepted as a pathogen responsible for opportunistic in- fections of the skin, bloodstream, urinary tract, and other soft tissues (3). The overall preponderance of Acinetobacter infection varies in different geographical areas as well as in different clinical settings due to differences in its related identified risk factors, the difference in hospital-based managerial and controlling approaches, and also the rate of resistance against various antibiotics (4). The common risk factors discovered for Acinetobacter infections include cigarette and alcohol use, diabetes mellitus, chronic pul- monary disorders, prolonged hospitalization, surgeries, central venous catheter insertion, mechanical ventilation, intravenous feeding, and the use of broad-spectrum an- tibiotics (5, 6). The respiratory system is the most com- Copyright © 2018, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.